Neurological Rating Scales
In order to measure any changes in disease, doctors use a neurological rating scale to measure its symptoms. Working on the assumption that symptoms reflect disease severity and activity, doctors can determine the best way to treat each patient.
When used regularly, neurological rating scales allow doctors to record how quickly a long lasting (chronic) disease, such as MS, is progressing - if indeed it is progressing at all. Most neurological rating scales measure disease progression in terms of impairment, disability or handicap.
- Impairment - parts of the body not working properly
- Disability - restriction of normal activities because parts of your body are not working properly
- Handicap - restricting a whole range of normal activities because of the impairment that prevents a person fulfilling a particular role
The main scale used in MS is called the Expanded Disability Status Scale or EDSS. The EDSS is partly based on measurements of eight areas of the central nervous system known as functional systems. The earlier steps in the scale measure the degree of impairment in these systems, such as numbness in the face or fingers - or visual disturbances. Later steps measure disability in terms of mobility mainly based on walking distances.
- pyramidal - voluntary movement e.g. walking
- brainstem - functions like eye movement, sensation and movement of the face, swallowing
- visual - seeing
- cerebral - memory, concentration, mood
- cerebellar - coordination of movement or balance
- sensory - feeling e.g. touch
- bowel and bladder
- others - including fatigue